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General NPI Number Information
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NPI Number | 1922128172
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Entity Type | Organization
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Legal Business Name | KRISTIN BUSSEY-SMITH MD PA
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 05/04/2009
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Provider Practice Location Address
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Address Line | 19260 STONE OAK PKWY SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3365
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Country | US
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Telephone | 210-495-4335
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Fax | 210-587-7415
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Provider Business Mailing Address
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Address Line | 19260 STONE OAK PKWY SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3365
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Country | US
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Telephone | 210-495-4335
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Fax | 210-587-7415
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KRISTIN LOUISE BUSSEY-SMITH
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Credential | M.D.
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Telephone | 210-495-4335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | M5080
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | M5080
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | M5080
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | M5080
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | M5080
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License Number State | TX
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